Utility of lateral flow tests in SARS-CoV-2 infection monitorization.

OBJECTIVE: The diagnosis of SARS-CoV-2 infection is crucial for medical and public health reasons, to allow the best treatment of cases and the best control of the pandemic. Serology testing allows for the detection of asymptomatic infections and 19-COVID cases once the virus has been cleared. We analyzed the usefulness of the SARS-CoV-2 rapid test of Autobio and tried to correlate its pattern with the severity of COVID19 infection. METHODS: We analyzed the accuracy and clinical usefulness of a point-of-care IgM and/or IgG test for SARS-CoV-2 in 35 COVID-19 patients [12 (34.3%) mild-moderate and 23 (65.7%) severe-critical] admitted to a field hospital in Madrid, as well as in 5 controls. RESULTS: The mean time from the first day of symptoms to the antibody test was 28 days (SD: 8.7), similar according to the severity of the disease. All patients with SARS-CoV-2 PCR+ showed the corresponding IgG positivity, while these results were negative in all control individuals. A total of 26 (74%) cases also presented with positive IgM, 19 (83%) were severe-critical cases and 7 (58%) were mild-moderate cases. The IgM response lasted longer in the severe critical cases (mean: 29.7 days; SD: 8.4) compared to the moderate cases (mean: 21.2 days; SD: 2.0).. CONCLUSIONS: Rapid serology tests are useful for the diagnosis of patients with COVID-19 (mainly IgG detection) and may also be correlated with the severity of the infection (based on IgM detection).

[EFQM Model in the hospitals of Madrid Regional Health Service: full self-assessment cycle]. / Modelo EFQM en los hospitales del Servicio Madrileño de Salud: ciclo completo de autoevaluación.

AIM: To analyse a complete cycle of self-assessment using the European Foundation for Quality Management (EFQM) Model in the hospitals of the Madrid Health Service as regards the fundamental concepts of excellence (FCE). METHOD: Descriptive study of the EFQM self-assessments of the entire public hospital sector identifying the methodology and the information on strengths, weaknesses, evidence, RADAR matrix (Results, Approach, Deployment, Assessment and Review), and the related FCEs in the enabling criteria and in the prioritised action plans. RESULTS: The self-assessment was carried out in 85% of the hospitals (29/34), 86% of them required specific training (25/29), with a total of 329 teaching hours and 833 people in training. Multidisciplinary working groups were required in 83% of the hospitals (24/29), with 123 groups and 857 people involved. There were 3,686 strengths and 3,197 weaknesses identified: strengths and weaknesses were 78% (2,869) and 74% (2,355), respectively, for the enabling criteria and 22% (817) and 26% (842), respectively, for the results criteria. The mean score was 404 points with a median of 399. The main FCEs were managing with agility, developing organisational capability, sustaining outstanding results, creating a sustainable future, succeeding through the talent of people, and adding value for customers, with harnessing creativity/innovation and leading with vision, inspiration and integrity being placed in lower positions. A total of 113 action plans were identified for all the hospitals. CONCLUSION: A complete EFQM self-assessment cycle of the entire public hospital sector of a Regional Health Service is provided, linking the analysis and action plans with the FCE of the EFQM Model.

Chiral bidentate [N,S]-ferrocene ligands based on a thiazoline framework. Synthesis and use in palladium-catalyzed asymmetric allylic alkylation.

An efficient method to obtain chiral 1,2-disubstituted ferrocenyl ligands has been developed. The introduction of planar chirality was accomplished by using 2-thiazoline as an ortho-directing lithiation group, and moreover, these kinds of ligands possess a central chirality from the amino alcohol used in their synthesis. The X-ray analysis and DFT calculations confirmed the diastereoselectivity of ortho-lithiation and the configuration of the planar chirality. The ability of these new bidentate [N,S]-ferrocene ligands to act in Pd-catalyzed asymmetric allylic alkylation has also been demonstrated and compared with their oxazoline counterparts.

Childbirth care practices in public sector facilities in Jeddah, Saudi Arabia: a descriptive study.

OBJECTIVES: to explore reported hospital policies and practices during normal childbirth in maternity wards in Jeddah, Saudi Arabia, to assess and verify whether these practices are evidence-based. DESIGN: quantitative design, in the form of a descriptive questionnaire, based on a tool extracted from the literature. SETTING: nine government hospitals in Jeddah, Saudi Arabia. These hospitals have varied ownership, including Ministry of Health (MOH), military, teaching and other government hospitals. PARTICIPANTS: key individuals responsible for the day-to-day running of the maternity ward. MEASUREMENTS: nine interviews using descriptive structured questionnaire were conducted. Data were analysed using SPSS for Windows (version 16.0). FINDINGS: the surveyed hospitals were found to be well equipped to deal with obstetric emergencies, and many follow evidence-based procedures. On average, the caesarean section rate was found to be 22.4%, but with considerable variances between hospitals. Some unnecessary procedures that are known to be ineffective or harmful and that are not recommended for routine use, including pubic shaving, enemas, episiotomy, electronic fetal monitoring (EFM) and intravenous (IV) infusion, were found to be frequently practiced. Only 22% of the hospitals sampled reported allowing a companion to attend labour and childbirth. KEY CONCLUSIONS: many aspects of recommended EBP were used in the hospitals studied. However, the results of this study clearly indicate that there is wide variation between hospitals in Jeddah, Saudi Arabia in some obstetric practices. Furthermore, the findings suggest that some practices at these hospitals are not supported by evidence as being beneficial for mothers or infants and are positively discouraged under international guidelines. IMPLICATIONS FOR PRACTICE: this study has specific implications for obstetricians, midwives and nurses working in maternity units. It gives an overview of current hospital policies and practices during normal childbirth. It is likely to contribute to improving the health and well-being of women, and have implications for service provision. It could also help in the development of technical information for policy-makers, and health care professionals for normal childbirth care.

Síncope de esfuerzo y riesgo de muerte súbita en deportistas jóvenes: perspectiva clínica y genética / Exercise-induced syncope in young athletes and risk of sudden death: clinical and genetic perspectives

El síncope puede ser en ocasiones el resultado o aviso de patologías potencialmente graves y en ocasiones mortales. Los servicios de urgencias (SU) son primordiales para estratificar el riesgo de los pacientes con síncope. La historia clínica dirigida la exploración física y el Electrocardiograma de 12 derivaciones (ECG) identifican las causas del síncope en la mitad de los pacientes. Hay una serie de alteraciones, como anormalidades en el ECG, Patología cardiaca previa, Presión arterial sistólica elevada, alteraciones del patrón respiratorio, descenso del hematocrito, edad avanzada, síncope de esfuerzo o la historia familiar de muerte súbita, que nos señalan a los pacientes de riesgo. La cardiopatía estructural y la enfermedad cardiaca congénita o eléctrica primaria son los principales factores de riesgo de muerte súbita cardiaca y de la mortalidad global en los pacientes con síncope. En estos pacientes la sensibilidad diagnóstica de las pruebas convencionales disponibles es aún hoy en día escasa. La Muerte súbita cardiaca (MSC) normalmente se debe a taquicardia/fibrilación ventricular sostenidas. La causa más frecuente es cardiopatía isquémica, pero en el grupo de pacientes menores de 35 años existen una serie de enfermedades que constituyen la causa más prevalente de MSC. En los últimos dos años el desarrollo de los estudios genéticos cardiovasculares puede haber abierto una vía diagnóstica en un grupo de pacientes con enfermedades congénitas cardiacas que les predisponen a MSC. Enfermedades como la Displasia arritmogénica del ventrículo derecho (DAVD), la Miocardiopatía Hipertrófica obstructiva (MHC),el Síndrome del QT Largo congénito (SQTLC), la Taquicardia Ventricular Catecolaminérgica, el Síndrome de Wolf-parkinson-White (WPW) o el Síndrome de Brugada se analizan en esta revisión (AU)

Syncope may be a warning sign of potentially serious and even life-threatening medical conditions. Emergency service expertise is essential for assessing risk in patients with syncope. A focused medical history and a physical examination that includes a 12-lead electrocardiogram (ECG) will identify the causes of syncope in half the patients. Patients at riskare those with certain ECG abnormalities, a history of heart disease, elevated systolic pressure, changes in breathing pattern, a fall in the hematocrit level, older age, exercise-induced syncope, or a family history of sudden death. Structural heart disease (congenital heart disease or primary electrical abnormalities) are the main risk factors of sudden cardiacdeath (SCD) and all mortality in patients with syncope. The diagnostic sensitivity of conventional tests remains low in these patients. SCD is normally due to sustained tachycardia (ventricular fibrillation). The most common cause overall is ischemic heart disease, but in patients under the age of 35 years a series of diseases have been implicated as the most frequent causes. The past 2 years have seen studies of genetic factors involved in cardiovascular disease that have suggested the possibility of diagnosis for certain patients with congenital heart diseases that predispose them to SCD. This review includes discussions of such conditions as arrhythmogenic right ventricular dysplasia, obstructive hypertrophic cardiomyopathy, congenital long QT syndrome, catecholaminergic ventricular tachycardia, Wolf-Parkinson-White syndrome, or Brugada syndrome (AU)

Valuing health care businesses.

Home care agencies have unique factors that contribute to their value--factors that are not always apparent. Do prospective buyers or owners who wish to sell know how to arrive at that value and approach the market?